Quality Measures Research Articles

Study on Indoor Air Quality Measurement of Educational Buildings in Pakistan

Study on Indoor Air Quality Measurement of Educational Buildings in Pakistan

Deriving a measure for the environmental quality of life of an ultra-dense urban setting

Deriving a measure for the environmental quality of life of an ultra-dense urban setting

Age- and sex-adjusted CT-based reference values for temporal muscle thickness, cross-sectional area and radiodensity

Muscle mass has been traditionally assessed by measuring paraspinal muscle areas at the level of the third lumbar vertebra on computed tomography (CT). Neurological or neurosurgical patients seldom undergo CT scans of the lumbar region. Instead, temporal muscle thickness (TMT), cross-sectional area (TMA) and radiodensity measured from head CT scans are readily available measures of muscle mass and quality in these patient cohorts. The purpose of this retrospective study was to establish CT-based reference values for TMT, TMA and radiodensity for each decade of age from 0 to 100 years normalized by age and sex, and to define cut-off values for subjects at risk for sarcopenia as defined by the European Working Group on Sarcopenia in Older People (EWGSOP). Subjects diagnosed with a concussion at the Oulu University Hospital between January 2014 and December 2022 (n = 9254) were identified to obtain a reference population. Subjects with significant pre-existing co-morbidities were excluded. TMT, TMA and radiodensity were measured, measurement reliability was quantified, and sex-adjusted reference values were calculated for each age decade. Quantile regression was used to model age-related changes in muscle morphomics. A total of 500 subjects [250 (50.0%) males] with a mean age of 49.2 ± 27.9 years were evaluated. Inter- and intra-observer reliability was almost perfect for TMT and TMA, and substantial-to-almost perfect for radiodensity. The mean TMT, TMA and radiodensity were 5.2 ± 1.9 mm, 284 ± 159 mm2 and 44.6 ± 17.7HU, respectively. The cut-off values for reduced TMT, TMA and radiodensity for males/females using the European Working Group on Sarcopenia in Older People compliant criteria were ≤ 4.09 mm/≤3.44 mm, ≤ 166 mm2/≤156 mm2, and ≤ 35.5HU/≤35.2HU, respectively. We described a standardized CT-based TMT and TMA measurement protocol practical for clinical use with almost perfect reliability. Using the protocol, we produced quantile regression models for the detection of reduced TMT, TMA and radiodensity at the lowest 5th, 10th, 20th, 30th, 40th and 50th percentiles as well as the EWGSOP compliant criteria cut-off values for reduced muscle mass to facilitate generalizable radiological sarcopenia research.

A Framework for Behavioral Health Integration in the Program of All-Inclusive Care for the Elderly (PACE).

The Program of All-inclusive Care for the Elderly (PACE) is a comprehensive care model that aims to promote aging in the home and community for older adults who are nursing-home eligible needs-wise. Older adults experience age-related barriers to accessing behavioral health (BH) services. PACE programs play an important role in providing all-inclusive health care for individuals over 55 who are dually eligible for Medicaid and Medicare. This article investigates behavioral health integration (BHI) within PACE Organizations (POs), produces a conceptual framework for BHI within PACE, and reports on current BH practices and programmatic needs to support the growing BH needs of participants. The team adapted the BH-Serious Illness Care (BH-SIC) Model, to produce a conceptual framework for BHI within PACE (BHI-PACE Model). The model informed a mixed-methods sequential approach to assess BHI at POs that include (i) a survey, (ii) use-case interviews of POs, and (iii) qualitative analyses of interviews. We present the domains and subdomains for the BHI-PACE Model. With respect to the national BH in PACE assessment, 38 POs representing 119 sites and 25,806 participants participated in the survey and 15 POs representing 58 sites and 10,029 participants participated in interviews. Survey results revealed a high rate of BH comorbidities among PACE participants (60% median rate, IQR: 70-44). The most common reasons for referral to BH specialists were depression and mood disorders 92.1%, behavioral and psychological symptoms of dementia (BPSD) 57.9%, and anxiety disorders 55.3%. POs' current BH practices and challenges can guide other POs to better integrate BH. Integrating BH into the PACE model requires policy-level action, though quality measurement and value-based care efforts can support this endeavor.

RIDE QUALITY MEASUREMENT AND USER RATINGS: INITIAL ASSESSMENT OF IMPROVED TECHNIQUES

Improved techniques for assessing ride quality have been developed by the authors that closely simulate actual vehicle ride dynamics and the responses of humans to whole-body vibration. Using numerical models to simulate four generic road-user vehicle classes – passenger cars, heavy commercial vehicles (trucks), off-road recreational and sports utility vehicles (SUVs) and motorcycles – fundamental issues associated with current ride quality measurements are addressed leading to more robust and accurate estimates of pavement rideability. Initial field trials and tests of the proposed ride quality model for a passenger car were conducted. To assess the effectiveness of the model as a ride quality predictor, the overall modelled ride responses were compared with actual measured ride vibrations (objective measures) and road-user ride ratings (subjective measures), all taken on the same sections of pavements. For the objective measures of ride quality portable vibration measuring equipment, comprising accelerometers, event markers and a data logger were assembled, customised and tested. In later versions of the equipment, also described in this paper, GPS tracking was incorporated to provide precise time-based recordings of location and speed. Developed specifically for this project, the equipment is small in size, completely self-contained, and is readily adapted for use in both small and large vehicles (motorcycles, cars, SUVs and trucks). The initial study found there was good agreement between the modelled responses, vibration measurements and subjective ratings. A further larger study is planned, which is discussed in this paper.

The Relationship between Various Measures of Perinatal Quality.

To examine the correlations between pairs of maternal, infant, and maternal-infant dyad quality measures to provide a comprehensive assessment of perinatal care. In a retrospective cohort study using birth and fetal death certificates linked to hospital discharge data from Michigan, Oregon, Pennsylvania, and South Carolina (2016-2018), we examined correlations between pairs of maternal, infant, and maternal-infant dyad quality measures. Maternal quality measures included nulliparous term singleton vertex (NTSV) cesarean birth, non-transfusion severe maternal morbidity (SMM), and a composite maternal outcome. Infant quality was assessed with a composite outcome measure, while the dyad measure combined maternal and infant outcomes. Among 955,904 dyads across 266 hospitals, 25.9% had NTSV, 0.7% had non-transfusion SMM, 12.3% had the composite infant measure, and 19.3% had the dyad measure. The correlation between non-transfusion SMM and the dyad measure was 0.12 while the correlation between the composite infant measure and the dyad measure was 0.86 which was higher than the correlation between the composite maternal measure and the dyad measure (0.47). We observed minimal correlations among these perinatal quality measures, especially when aggregated beyond individual outcomes.

EXamining the feasibility of exerCisE to manage symptoms of Lupus (EXCEL): a protocol for a randomised controlled pilot study

IntroductionSLE is a chronic autoimmune disease that results in sustained hyperactivation of innate and adaptive immune cells and widespread inflammatory damage. Regular exercise reduces SLE symptoms including fatigue and joint...

Impact of foreign direct investment on economic growth in developing countries: The role of institutional quality

This paper empirically examines the impact of institutional quality on FDI-driven economic growth in 135 developing countries from 1996–2020. Given that improved institutions lower business costs, reduce uncertainty, and attract FDI inflow, the study hypothesizes that enhancing institutional quality will likely foster higher economic growth in developing countries through FDI. We apply dynamic and static panel estimation techniques for this investigation. The research employs six measures of institutional quality from the World Governance Indicators (WGI) and their interaction with FDI inflow to identify key institutional quality indicators for developing countries. Results indicate a positive and significant effect of FDI on economic growth in developing countries. Moreover, enhancements in three specific institutional quality indicators—government effectiveness, regulatory quality, and the rule of law—strengthen FDI’s impact on economic growth. The study also underscores the greater significance of institutional quality in driving FDI-led economic growth in developing countries, compared to its limited impact on all countries. Ultimately, the study recommends that policymakers in developing countries devise effective strategies to enhance government effectiveness, regulatory quality, and the rule of law to expedite economic growth through FDI.

Manajemen Pelayanan Publik

This research discusses public service management in Indonesia with a focus on service quality, management implementation and performance measurement. Through a qualitative approach, this research reviewed various literature sources that identified factors that influence the quality of public services, such as technology, human resources and service processes. It found that the implementation of digital technology and e-government can improve efficiency and transparency, while the development of HR competencies through training is also very important. However, challenges such as inequality between urban and rural areas, cumbersome bureaucracy, and lack of professionalism of state apparatus are still obstacles. The research also emphasizes the importance of community participation in public service improvement. Overall, public service management in Indonesia requires continuous efforts in bureaucratic reform, improving the quality of human resources, and utilizing technology to realize services that are more efficient, transparent, and responsive to community needs.

Effects of Art Therapy on Quality of Life and Social Functioning in Individuals With Schizophrenia.

To investigate the effect of art therapy on quality of life and social functioning of individuals with schizophrenia receiving community mental health services. A quasi-experimental study design was used to assess the effects of art therapy on quality of life and social functioning. The study included 14 participants with schizophrenia, seven assigned to the intervention group and seven to the control group. The intervention group participated in weekly art therapy sessions encompassing various artistic modalities over 16 weeks. Pre- and post-test measurements of quality of life and social functioning scales were administered to both groups. A significant increase was noted in total scores of quality of life and social functioning scales for the intervention group between pre- and post-test. No significant differences were observed within the control group. The current study suggests that art therapy promotes quality of life and social functioning of individuals with schizophrenia. Art therapy may be suggested as a psychiatric rehabilitation approach; however, more evidence-based studies are needed for this intervention to be integrated into routine clinical treatment. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Home Health Care Research for Children With Disability and Medical Complexity.

Pediatric home health care represents a vital system of care for children with disability and medical complexity, encompassing services provided by family caregivers and nonfamily home health care providers and the use of durable medical equipment and supplies. Home health care is medically necessary for the physiologic health of children with disability and medical complexity and for their participation and function within home, school, and community settings. While the study of pediatric home health care in the United States has increased in the last decade, its research remains primarily methodologically limited to observational studies. Dedicated funding and research efforts are needed to transform American home health care research to address multifaceted outcomes valued by families and providers as well as payers and government programs. In this paper, we review the recent literature in pediatric home health care and then propose an actional agenda that could address its missing evidence base. We posit that pediatricians should partner with family caregiving experts and patients to advance knowledge about child and family health outcomes, home health care use, new models of care, and optimal approaches to education and training while also considering meaningful approaches to address disparities. The creation of an American pediatric home health care data-sharing consortium, patient registry, and reproducible access and quality measures is also needed. Most importantly, efforts should center on patient- and family-centered health priorities, with the goal of ensuring equitable outcomes for every child and family.

A Comprehensive Approach to Reducing Patient Safety Indicators (PSI-90).

PSI-90, a composite measure comprising ten indicators, reflects the quality of care during hospital stays. The Hospital-Acquired Condition Reduction Program (HACRP), a Centers for Medicare and Medical Services (CMS) program, assesses hospital performance based on quality measures, including PSI-90, with financial implications for poor performers. To evaluate PSI events, establish workflows for accurate documentation, and foster collaboration across clinical and administrative teams, with the ultimate objective of reducing PSI events. Essential actions involved designating a PSI nurse reviewer and a quality physician advisor, securing the involvement of executive leadership, adopting computer-assisted coding technology, and promoting teamwork among Clinical Documentation Improvement (CDI), coding, and Health Information Management (HIM) teams. The collaborative efforts yielded a 45% reduction in PSI events, leading to estimated cost avoidance of $1.4 million, and exemption from HACRP penalties. Lessons learned encompassed the importance of executive leadership support, data-driven decision-making, and ongoing education. This study shows the significance of collaboration, leadership support, and data utilization in PSI reduction efforts. Furthermore, it shows benefit of a surgical quality officer in advancing patient safety, aligning with ACS recommendations.

Acceptance, Safety, and Effect Sizes in Online Dialectical Behavior Therapy for Borderline Personality Disorder: Interventional Pilot Study.

The potential of telehealth psychotherapy (ie, the online delivery of treatment via a video web-based platform) is gaining increased attention. However, there is skepticism about its acceptance, safety, and efficacy for patients with high emotional and behavioral dysregulation. This study aims to provide initial effect size estimates of symptom change from pre- to post treatment, and the acceptance and safety of telehealth dialectical behavior therapy (DBT) for individuals diagnosed with borderline personality disorder (BPD). A total of 39 individuals meeting the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) criteria for BPD received 1 year of outpatient telehealth DBT at 3 sites in Germany and Canada. Effect size estimates were assessed using pre-post measures of BPD symptoms, dissociation, and quality of life. Safety was evaluated by analyzing suicide attempts and self-harm. Additionally, acceptance and feasibility, satisfaction with treatment, useability of the telehealth format, and the quality of the therapeutic alliance were assessed from both therapists' and patients' perspectives. All analyses were conducted on both the intention-to-treat (ITT) and according-to-protocol (ATP) samples. Analyses showed significant and large pre-post effect sizes for BPD symptoms (d=1.13 in the ITT sample and d=1.44 in the ATP sample; P<.001) and for quality of life (d=0.65 in the ITT sample and d=1.24 in the ATP sample). Dissociative symptoms showed small to nonsignificant reductions. Self-harm behaviors decreased significantly from 80% to 28% of all patients showing at least 1 self-harm behavior in the last 10 weeks (risk ratio 0.35). A high dropout rate of 38% was observed. One low-lethality suicide attempt was reported. Acceptance, feasibility, and satisfaction measures were high, although therapists reported only moderate useability of the telehealth format. Telehealth DBT for BPD showed large pre-post effect sizes for BPD symptoms and quality of life. While the telehealth format appeared feasible and well-accepted, the dropout rate was relatively high. Future research should compare the efficacy of telehealth DBT with in-person formats in randomized controlled trials. Overall, telehealth DBT might offer a potentially effective alternative treatment option, enhancing treatment accessibility. However, strategies for decreasing drop-out should be considered. German Clinical Trials Register DRKS00027824; https://drks.de/search/en/trial/DRKS00027824.

The Relationships between Subjective Wellbeing and Frailty: Staying with a Positive Mind, Stepping away from Accelerated Aging.

Subjective wellbeing (SWB) is a crucial measure of life quality in older adults. Understanding its relationship with frailty may inform strategies to promote healthy aging. We analyzed data for older adults aged ≥ 60 years old from Waves 3 and 4 of the China Health and Retirement Longitudinal Study. SWB was measured based on participants' self-reported overall satisfaction with life. A frailty index was developed using the deficit accumulation approach. We conducted a cross-sectional Poisson regression to investigate the relationship between SWB and counts of frailty deficits. Additionally, we conducted a longitudinal analysis to determine the three-year relative risk of clinically significant frailty progression or mortality for different levels of SWB. The analyses were adjusted for individual weights, including adjustments for household nonresponse. The cross-sectional analysis included 9,702 individuals. After adjusting for covariates, lower baseline life satisfaction was associated with higher counts of frailty deficits (mean deficit counts ratio [95% confidence interval]: 1.66 [1.54, 1.78] for "not satisfied" and 1.06 [1.02, 1.10] for "somewhat satisfied" relative to the reference "very satisfied"). The longitudinal analysis included 8,599 individuals. Participants who were "not satisfied" with life at baseline were at a greater risk of frailty progression compared with those who were "very satisfied" (risk ratio: 1.16 [1.00, 1.35]). Our study finds that a lower level of SWB is associated with more severe frailty. It is also associated with frailty progression or death. These results emphasize that both psychological wellbeing and physical health are essential components of healthy aging.

Assessing the impact of mindfulness programs on attention-deficit/ hyperactivity disorder in children and adolescents: a systematic review

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder which poses challenges for the individuals with the disorder and their families. While stimulant medications are effective, a comprehensive approach, including psychosocial and behavioral interventions, is recommended. There is a growing body of research exploring the potential benefits of mindfulness-based interventions for children with ADHD. Our study aims to assess the effectiveness of mindfulness interventions in reducing ADHD symptoms in children and adolescents through a systematic review of relevant studies.MethodsFollowing PRISMA guidelines, our systematic review searched PubMed, Cochrane library, Psycinfo, and Scopus from January 2000 to August 2022. We included studies focusing on mindfulness for pediatric ADHD, comprising various study designs with a minimum 8-week duration. Descriptive statistics summarized results, while risk of bias was assessed using Cochrane RoB and ROBANS tools. The quality of RCTs was further evaluated using the Correlation of Quality Measures tool.ResultsIn the initial search, 450 records were identified, and after removing duplicates, 339 underwent screening. Forty-one studies underwent full text assessment for eligibility, with 11 studies meeting inclusion criteria, including seven RCTs, two Quasi RCTs, and three cohort studies. These studies, conducted in five countries, involved participants aged 7 to 18 years. Six studies showed improvement in hyperactivity/inattentive symptoms, and five studies showed improvement in impulsivity.ConclusionsThis systematic review demonstrates the potential benefits of mindfulness programs on ADHD symptoms in children and adolescents. This study emphasizes the need for high-quality research to explore mindfulness-based interventions for ADHD management in younger populations.PROSPERO registration number: IDCRD42024520800

Impact of Disease Etiology and Indication for Colectomy on Postoperative Outcomes: A NSQIP Colectomy-Targeted Database Study.

The ACS-NSQIP Colectomy-Targeted database provides valuable metrics on surgical outcomes by utilizing clinical data to enhance quality improvement efforts. However, the quality measures offered in the ACS-NSQIP semiannual report do not stratify for the indication for colectomy. We aim to compare postoperative outcomes in patients undergoing colectomy for colon cancer, infectious causes, and inflammatory bowel disease (IBD). A retrospective review of patients undergoing colectomy was performed using the ACS-NSQIP Colectomy-Targeted database from 2012-2022. Logistic regression models were used to compare the 30-day postoperative outcomes of patients who underwent colectomy for colon cancer, infectious causes, and IBD while adjusting for pre-operative risk factors. There were 158,560 patients who underwent colectomy for colon cancer, 90,827 patients for infectious causes, and 30,548 patients for IBD. In unadjusted analysis, patients undergoing colectomy for infectious causes had the highest rates of mortality (2.6%) and morbidity (27.6%). After adjusting for covariates, IBD patients undergoing colectomy had significantly higher odds of morbidity compared to those undergoing colectomy for colon cancer (OR 1.3, 95% CI [1.1, 1.4]) and infectious causes (OR 1.3, [1.2, 1.4]). Furthermore, IBD patients had significantly higher odds of experiencing venous thromboembolism, surgical site infections, prolonged ileus, and readmission within 30 days compared to both colon cancer and infectious causes patients. This study demonstrates that the indication for colectomy impacts postoperative outcomes. Reporting risk-adjusted outcomes based on the underlying disease etiology could lead to identifying high-risk patients, improving benchmarking outcomes, and developing targeted quality initiatives.

Comparing prediction accuracy for 30-day readmission following primary total knee arthroplasty: the ACS-NSQIP risk calculator versus a novel artificial neural network model

BackgroundUnplanned readmission, a measure of surgical quality, occurs after 4.8% of primary total knee arthroplasties (TKA). Although the prediction of individualized readmission risk may inform appropriate preoperative interventions, current predictive models, such as the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator (SRC), have limited utility. This study aims to compare the predictive accuracy of the SRC with a novel artificial neural network (ANN) algorithm for 30-day readmission after primary TKA, using the same set of clinical variables from a large national database.MethodsPatients undergoing primary TKA between 2013 and 2020 were identified from the ACS-NSQIP database and randomly stratified into training and validation cohorts. The ANN was developed using data from the training cohort with fivefold cross-validation performed five times. ANN and SRC performance were subsequently evaluated in the distinct validation cohort, and predictive performance was compared on the basis of discrimination, calibration, accuracy, and clinical utility.ResultsThe overall cohort consisted of 365,394 patients (trainingN = 362,559; validationN = 2835), with 11,392 (3.1%) readmitted within 30 days. While the ANN demonstrated good discrimination and calibration (area under the curve (AUC)ANN = 0.72, slope = 1.32, intercept = −0.09) in the validation cohort, the SRC demonstrated poor discrimination (AUCSRC = 0.55) and underestimated readmission risk (slope = −0.21, intercept = 0.04). Although both models possessed similar accuracy (Brier score: ANN = 0.03; SRC = 0.02), only the ANN demonstrated a higher net benefit than intervening in all or no patients on the decision curve analysis. The strongest predictors of readmission were body mass index (> 33.5 kg/m2), age (> 69 years), and male sex.ConclusionsThis study demonstrates the superior predictive ability and potential clinical utility of the ANN over the conventional SRC when constrained to the same variables. By identifying the most important predictors of readmission following TKA, our findings may assist in the development of novel clinical decision support tools, potentially improving preoperative counseling and postoperative monitoring practices in at-risk patients.

Age-related trends in trabecular bone scores and bone mineral density in Chinese men with type 2 diabetes mellitus: a cross-sectional study

Patients with Type 2 diabetes mellitus(T2DM) typically have an average or higher bone mineral density (BMD) but are at a significantly higher risk of fracture than patients without diabetes. Trabecular bone score (TBS) is a textural index derived from pixel gray-level variations in lumbar spine DXA image, which has been introduced as an indirect measure of bone quality. This study aimed to discuss the trends and annual rates of change in BMD and TBS with age in Chinese men with T2DM and men without diabetes mellitus. Lumbar spine(LS) TBS was significantly lower in males with T2DM compared to men without diabetes(1.279 ± 0.117 vs. 1.299 ± 0.090, P = 0.005). However, TBS in men with T2DM peaked around age 60, which occurred later and was lower than the peak observed in men without diabetes, who reached their peak TBS around age 50 (1.294 ± 0.126 vs. 1.328 ± 0.088). Femoral neck, total hip, and lumbar spine BMD in men with T2DM were not significantly different from those in men without diabetes. The results showed that both men with or without T2DM exhibited the lowest annual rates of change in TBS at 66–75 years of age, with values of -1.05%(P < 0.001) and − 0.90%(P < 0.001), respectively. Patients with great glycemic control demonstrated higher TBS and BMD. Men with T2DM have later and lower peak TBS and faster bone loss, suggesting that diabetes may negatively impact bone microarchitecture and mineralization.

Time-dependent, patient-centered perceptions of quality measures for total joint arthroplasty: a cross-sectional, choice modeling study

BackgroundAs value-based care arrangements continue to assess quality of care and costs, comprehensive and patient-centered definitions of quality of care are required. While patient-reported outcome measures are increasingly integrated into quality assessments following total joint arthroplasty (TJA), patient perceptions of quality paired with the phase of surgical care has not been described. The purpose of this study was to assess how TJA patients perceive measures of quality of care and assess if these perceptions change based on the phase of care.MethodsPatients who had undergone a TJA within the past two years or had a scheduled TJA within the next 6 months completed a questionnaire designed using best-worst scaling, a method used to measure individuals’ priorities by asking participants to make repeated selections of the best and worst items in a series of subsets of items. Subanalyses were calculated to compare each phase of care (preoperative, short term postoperative, and long term postoperative).ResultsA total of 153 patients completed the questionnaire; 36 were preoperative, 55 were short term postoperative, and 62 were long term postoperative. Patients placed the highest value on improving activities of daily living (β = 1.03, CI = 0.90-1.16), decreasing pain (β = 0.65, CI = 0.53-0.76), and avoiding re-intervention (β = 0.64, CI = 0.52-0.76). Decreasing pain ranked as a higher priority preoperatively compared to short term postoperatively, and subsequently increased in priority again after 6 months. Avoiding reintervention was less important to patients preoperatively compared to postoperatively. Avoiding complications was more important to patients preoperatively compared to postoperatively.ConclusionsMatching outcome assessments with how patients assess their quality of care throughout the TJA recovery process can inform phase-specific quality improvement initiatives and value definitions. Activities of daily living should be measured across phases of care and into long-term recovery. TJA value dashboards should align with these patient-driven perceptions of quality.Level of evidenceLevel III, cohort study.

Analyzing Urban Air Quality Perceptions: Integrating Socio-Demographic Patterns with Sensor-Based Measurements Using Regression Model and Multidimensional Scaling

In this study, the urban air quality perceptions are explored in the metropolitan area of Târgu Mureș, Romania, emphasizing the interaction between socio-demographic factors, air quality measures, and industrial activity. The research addresses the need to understand how public perceptions align with objective air quality data and industrial influences, aiming to support sustainable urban planning. Data were gathered through a structured survey of 321 respondents and complemented by air quality measurements, including PM2.5 and PM10, and industrial production data. Statistical analyses, such as regression models and multidimensional scaling (PROXSCAL), were applied to identify patterns and relationships between socio-demographic characteristics, perceived air quality, and environmental factors. The results reveal significant links between demographic factors (e.g., age, awareness of local initiatives) and perceptions of air quality, alongside a nuanced interaction between air quality indicators and industrial activity. Respondents frequently identified traffic and industrial emissions as major contributors to air pollution, which was corroborated by sensor data trends. The findings underline the importance of integrating public perceptions with empirical data to design targeted policies and foster community engagement. This comprehensive approach provides actionable insights for improving urban air quality and advancing sustainable practices in mid-sized cities like Târgu Mureș.